COVID-19

Federal Health Policy Update for March 23

The following is the latest health policy news from the federal government for March 17-23.  Some of the language used below is taken directly from government documents. No Surprises Act After a February ruling in federal court that aspects of CMS’s implementation of the 2020 No Surprises Act contradicted the language of the act itself and unfairly favored payers over providers, CMS ordered a moratorium on new arbitration decisions for disputes filed on or after October 25, 2022 while it reviewed and revised its guidance on how payment disputes should be decided.  Now, CMS has completed that task and issued [...]

Federal Health Policy Update for March 16

The following is the latest health policy news from the federal government for March 13-16.  Some of the language used below is taken directly from government documents. Medicare Payment Advisory Commission (MedPAC) MedPAC has published its “March 2023 Report to the Congress:  Medicare Payment Policy.”  In this year’s report MedPAC considers the context of the Medicare program, including the near-term consequences of COVID-19 and the longer-term effects of program spending on the federal budget and the program’s financial sustainability.  It evaluates payment adequacy and make recommendations concerning Medicare payment policy in 2024 for selected fee-for-service payment systems but explains that [...]

Federal Health Policy Update for Friday, March 10

The following is the latest health policy news from the federal government for March 6-10.  Some of the language used below is taken directly from government documents. White House FY 2024 Budget Proposal The Biden administration this week released its proposed FY 2024 federal budget.  Among its many proposals are measures to extend the life of the Medicare hospital trust fund and reduce Medicare beneficiaries’ health care costs; to reduce prescription drug costs for consumers, Medicare, and Medicaid; to return high Medicaid managed care organization profits to the federal government; to make behavioral health care more affordable for seniors; to [...]

Federal Health Policy Update for March 3

The following is the latest health policy news from the federal government for February 27 to March 3.  Some of the language used below is taken directly from government documents. No Surprises Act The Independent Dispute Resolution (IDR) entities empowered by the No Surprises Act to adjudicate disagreements between providers and payers may resume their work – but only some of it.  CMS has directed IDRs entities to resume processing payment determinations on February 27 for disputes involving items or services furnished before October 25, 2022 but not to issue decisions involving items or services furnished on or after October [...]

Federal Health Policy Update for February 23

The following is the latest health policy news from the federal government for February 17-23.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued an informational bulletin to states reiterating certain federal requirements that pertain to health care-related taxes.  Recently, CMS became aware that some health care-related tax programs appear to involve agreements among providers to redistribute their Medicaid payments to hold taxpayers harmless for the cost of the tax.  The bulletin reminds states that such arrangements are prohibited.  Find the CMS bulletin here. CMS has posted a [...]

End of PHE Spells End of Additional Money to Care for COVID Patients

When the COVID-19 public health emergency ends on May 11, the 20 percent increase in Medicare payments to hospitals caring for Medicare patients suffering from the disease will end as well. In the first two years under this payment policy, which took effect in January of 2020, the federal government paid more than $23 billion to hospitals caring for COVID patients.  Of that amount, 20 percent consisted of the supplemental payment. Learn more about the end of these additional payments and what it may mean for hospitals and Medicare beneficiaries from the Becker Hospital Review article “The 20% cut coming [...]

2023-02-22T06:00:27-05:00February 22, 2023|COVID-19, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for February 16

The following is the latest health policy news from the federal government for February 6-16.  Some of the language used below is taken directly from government documents. No Surprises Act A federal judge in Texas has vacated parts of a regulation governing the arbitration process that is a major aspect of implementation of the No Surprises Act.  In his ruling, the judge found that the arbitration process unfairly favored payers over providers, most notably by placing undue emphasis on the qualified payment amount (QPA) that is a major part of the arbitration process.  The decision explains that “The Court first [...]

Federal Health Policy Update for February 6

The following is the latest health policy news from the federal government for the week of January 23 to February 6.  Some of the language used below is taken directly from government documents. 340B Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided.  See the court’s ruling here. Centers for Medicare & Medicaid Services CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been [...]

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20.  Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.  The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment.  Go here for a summary of the update [...]

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12.  Some of the language used below is taken directly from government documents. Renewal of COVID-19 Public Health Emergency Declaration HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency.  This declaration extends the emergency to April 11.  The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency. MedPAC Medicare Rate Recommendations Every year MedPAC recommends to Congress rate increases for the different kinds of health care [...]

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